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Colorado College student's sleep study taps subjects' mindset

You've likely heard of the placebo effect, an outcome that cannot be attributed to a specific treatment or therapy but rather is caused by a patient's mindset alone. As it turns out, the force behind the placebo effect - namely our beliefs and perceptions - might be one of the more powerful health tools in our arsenal.

A study by a Colorado College senior found that students who were told they'd gotten a good night's sleep, even if they hadn't, performed better on tests that assessed attention and memory skills than students who were told they'd slept poorly, even if they were well rested. Christina Draganich based her results on two experiments with 164 students, and a paper about the study, "Placebo Sleep Affects Cognitive Functioning," was published this year in the Journal of Experimental Psychology: Learning, Memory and Cognition.

The placebo effect is potent, time-proven medicine. In fact, it's speculated that between 60 percent and 90 percent of drugs and physician-prescribed therapies work, at least in part, because patients believe they will.

The "nontraditional" placebo effect has been found to cause poison ivy in test subjects exposed to fake plants, physical improvements in people who'd undergone fake surgeries and a coffee high in those imbibing placebo caffeine. A team of Harvard researchers even found that a group of motel maids' beliefs that they were logging significant exercise for the day - absent any other factors - led to weight loss, improved blood pressure and decreased body fat over the course of the monthlong study.

"We've known about the regular placebo effect for thousands of years, but most of the time we hear about it in drug studies," said Kristi Erdal, a psychology professor at CC and faculty supervisor for the study. "It's only been in the last decade or two that people have begun exploring the nontraditional placebo effect, branching out and pushing the envelope to see how far that can take you. I think our mindset affects a lot more of our behavior and our physiology than we ever thought."

For her senior thesis in neuroscience, Draganich decided to see if the same concepts and manipulations could be applied to sleep.

"Throughout college, I saw how students focused on their lack of sleep before taking an exam. I wondered if their scores were maybe influenced by their attitude regarding how tired they thought they were," said Draganich, who graduated in 2012.

Because the study hinged on students' believing researchers could assess the quality of their previous night's sleep, Draganich had to devise a legitimate-seeming fabrication. As setup, she first asked participants to fill out a questionnaire about how well they believed they'd slept the previous night; the, they were brought into the lab for a five-minute lesson about sleep.

"I told them sleep quality can be measured by the percent of time spent in REM sleep, and sleep quality often predicts cognitive functioning," Draganich said. She then told them about a new, cutting-edge technique that allows researchers to assess an individual's REM sleep from the night before by measuring lingering biological markers such as heart rate and brain wave frequency.

"I know that sounds far-fetched - I did make it up," said Draganich, "but we had a lot of things on our side to lend authority." There were "complicated drawings" up on the board in the lab and students were connected to an EEG machine that responded to their movements.

Participants then were given real tests to measure cognitive functioning. Generally, those who were told they didn't get enough sleep scored lower, while people who were told they'd slept well achieved higher-than-average marks.

"What we were doing is looking at how an authority figure can affect a person's thinking and therefore their performance," Draganich said.

Draganich now works with spinal cord and brain injury patients at Craig Hospital in Denver, and plans to put what she learned from her sleep study to work in the exam room once she becomes a doctor.

"I've always been very interested in how attitude interacts with health," she said. "As a physician, it's important to remember how you frame information for your patients, whether positive or negative, can affect a patient's motivation or willingness to comply with care and therefore potentially their outcome."

In Erdal's 18 years at CC, this is only the fourth time one of her undergraduate research students has had a paper published in a prominent journal, which then led to coverage from media outlets including the BBC, Reader's Digest and Scientific American.

"What this says to me, proud mama of the study, is that science and the scientific method is at the disposal of anyone who will use it correctly," Erdal said. "Even if you're a 21-year-old in college, you can find enormously fascinating things if you do your homework and do the research."